A series of x-rays of the esophagus, stomach, and duodenum during and after drinking a barium solution. The duodenum is the first part of the small intestine; and the esophagus, stomach, and duodenum are collectively called the upper gastrointestinal (GI) tract or upper digestive system. 

PARTS OF THE BODY INVOLVED

Esophagus, stomach, duodenum

REASONS FOR PROCEDURE

An upper GI series may be ordered if you have:

  • Diarrhea
  • Weight loss
  • Abdominal pain
  • Difficulty swallowing
  • Regurgitation
  • Rectal bleeding
  • Bloody stools or black, tarry stools
  • Bloody vomit or "coffee-ground" vomit

An upper GI series can help detect:

  • A blockage
  • An abnormal growth or tumor
  • An ulcer
  • Diverticula - an abnormal pouch or sac opening from a hollow organ, such as the intestine
  • Gastroesophageal reflux disease (GERD)
  • A hiatal hernia
  • Crohn's disease
  • Pulmonary aspiration – inhalation of fluid, food, or other foreign matter into the lungs
  • Inflammation of the stomach or small intestine

RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE

  • Presence of food in the stomach
  • Presence of barium in the colon
  • Perforated or obstructed bowel

Due to the risks of radiation exposure, you should not have an upper GI series if you are pregnant.

WHAT TO EXPECT

Prior to Procedure:

  • Review your medications with your doctor, there are some that you may need to stop taking before this procedure
  • Do not eat, drink, or smoke for at least eight hours before
  • You may be given a medication called glucagon to slow down the activity of the stomach and small intestine
  • You may be asked to swallow baking soda crystals, which will bubble and produce gas in your stomach, allowing for more detailed x-rays
  • If you are going to have a small bowel follow-through, you may be asked to take a laxative medication the day before your exam, in order to clean out the small intestine

During Procedure – Barium sulfate solution

Anesthesia – None

Description of the Procedure - Remove all jewelry and wear a hospital gown. You drink barium, which is a thick, white, chalky milkshake-like liquid that coats the inside lining of the esophagus, stomach, and duodenum. As you drink the barium, the radiologist takes x-rays of the upper GI area, using a machine called a fluoroscope. If your doctor wants to examine the esophagus, you may have pictures taken as you actually swallow the liquid or small bits of food that are covered with barium. You will be asked to change positions frequently in order to coat the entire surface of the GI tract with barium.

If the radiologist wants to examine more of the small intestine, a small bowel follow-through may be done. For this exam, x-ray pictures are taken every 15-30 minutes while the barium travels through the intestine.

After Procedure – You may eat and drink as usual

How Long Will It Take? An upper GI series can take between 30 minutes and two hours. A small bowel follow-through can take 1-4 hours.

Will It Hurt? No. There should be no pain.

Possible Complications:

  • Constipation for a few days after the procedure
  • White stool
  • Necrosis (skin death) in some individuals (can usually be prevented)
  • Bowel obstruction, rare
  • Aspiration of the barium into your lungs, which can lead to pneumonia

Average Hospital Stay – None

Postoperative Care – Drink lots of fluids to eliminate the barium from your system

OUTCOME

A normal upper GI series will show an unobstructed, functioning, healthy digestive tract. Examples of abnormalities that may show up on an upper GI series include obstructions, ulcers of the esophagus, stomach, or small intestine, or irregularities in the swallowing mechanism. Your doctor will make treatment recommendations based on the findings.

CALL YOUR DOCTOR IF ANY OF THE FOLLOWING OCCURS

  • Abdominal pain or bloating
  • Constipation doesn't resolve within a few days
  • Signs of infection, including fever and chills
  • Redness, irritation, peeling, or sloughing of skin
SOURCE:

National Digestive Diseases Clearinghouse

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